宫颈癌患者合并静脉血栓栓塞症的危险因素和治疗

目的:探讨宫颈癌化疗患者合并静脉血栓栓塞症的危险因素与治疗.方法:回顾性分析2010年至2015年我院158例宫颈癌化疗患者,按是否合并静脉血栓栓塞症(VTE)分成VTE组(n=40)与无VTE组(n=118),记录分析两组的性别、年龄、既往史、病例类型、肿瘤分期、血小板计数、血黏稠度、D-二聚体以及治疗措施.结果:VET组Ⅳ期:90.00%,血黏稠度增高:67.50%,D-二聚体增高:70.00%;无VTE组Ⅳ期:70.34%,血黏稠度增高:46.61%,D-二聚体增高:49.15%(均P<0.05).Logistic回归显示:肿瘤分期、D-二聚体水平以及血黏稠度与宫颈癌化疗患者发生静脉血栓高度相关,差异均有统计学意义(均P<0.05).40例宫颈癌化疗合并VTE患者2例并发大出血死亡;其余经溶栓、抗凝治疗后19例治愈,4例好转,总有效率为57.50%.结论:宫颈癌肿瘤分期晚、D-二聚体水平高以及血黏稠度高与宫颈癌化疗患者发生静脉血栓高度相关,为宫颈癌患者并发VTE的高危因素;及时评价宫颈癌化疗患者合并VTE的高危因素,及早抗凝治疗,可预防及减少并发VTE,同时提高治疗效果.

Risk factors and treatment of cervical cancer patients complicated with venous thromboembolism

Objective:To explore the risk factors and treatment of cervical cancer patients with chemotherapy complicated with venous thromboembolism.Methods:Retrospectively analyze 158 cervical cancer patients with chemotherapy in our hospital from 2010 to 2015,according to whether or not combined with venous thromboembolism (VTE) divided into VTE group(n=40) and non-VTE group (n=118).To analyze the gender,age,history,case type,tumor stage,platelet count,blood viscosity,D-dimer,and therapeutic measures of the two groups.Results:In VTE group:Ⅳ stage was 90.00%,the viscosity of the blood was greater:67.50%,the level of two D-dimer greater 70.00%.Non-VTE group:Ⅳ stage 70.34%;the viscosity of the blood was greater 46.61%,the level of D-dimer greater 49.15%(P<0.05).Logistic regression analysis showed that tumor stage,D-dimer level and blood viscosity were highly correlated with venous thromboembolism in cervical cancer patients with chemotherapy,and the differences were statistically significant(P<0.05).2 cases of 40 cervical cancer patients with chemotherapy complicated with VTE were bleeded to death,others after thrombolysis,anticoagulation treatment,19 cases were cured,4 cases improved,the total effective rate was 57.50%.Conclusion:Cervical cancer in late stage,higher D-dimer level and higher blood viscosity were highly correlated with cervical cancer patients with chemotherapy complicated with venous thrombosis,and were the risk factors for cervical cancer patients with VTE.Evaluating of risk factors timely for cervical cancer patients with chemotherapy complicated with VTE,and anticoagulant therapy as early as possible that can prevent and reduce concurrent of VTE,and improve the treatment efficacy at the same time.